Inpatient magnetic resonance cholangiopancreatography: does it increase the efficiency in emergency hepatopancreaticobiliary surgery services?

Ann R Coll Surg Engl. 2017 Apr;99(4):289-294. doi: 10.1308/rcsann.2016.0291. Epub 2016 Sep 23.

Abstract

INTRODUCTION Magnetic resonance cholangiopancreatography (MRCP) is commonly used to evaluate the biliary tree, although indications for patients who require inpatient imaging are not fully defined. The aim of this study was to evaluate inpatient MRCP performed on surgical patients and to devise a treatment pathway for these patients. MATERIAL AND METHODS All adult inpatient MRCP examinations between January 2012 and December 2013 were reviewed. Demographic, clinical and radiological data were collated. RESULTS During the study period, 271 inpatient MRCP were requested, of which 234 examinations were included. The majority of patients were female (n=140) and the median age was 63 years (range 16-93 years). Surgical admissions accounted for 171 (73%) of cases. Indications for inpatient MRCP include gallstone-related complications (n=173; 74%), malignant process (n=17; 7%) and other indications (n=44; 19%). Overall, inpatient MRCP led to further inpatient interventions in 22% (gallstone group, n=32, 18%; patients with malignancy, n=8, 47%; other indications, n=12, 27%). The median duration of inpatient MRCP from request to examination was 2 days (range 0-15 days) and median reporting after examination was 1 day (range 0-14 days). DISCUSSION AND CONCLUSION Improved access and timely reporting of iMRCP may reduce length of hospital stay. Inpatient MRCP also led to further inpatient interventions, in particular, in patients with malignancy.

Keywords: Choledocholithiasis; Cholelithiasis; Magnetic resonance cholangiopancreatography.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bile Duct Neoplasms / diagnostic imaging*
  • Bile Duct Neoplasms / surgery
  • Cholangiopancreatography, Magnetic Resonance*
  • Cholecystectomy, Laparoscopic
  • Cholelithiasis / diagnostic imaging*
  • Cholelithiasis / surgery
  • Efficiency, Organizational*
  • Female
  • Hospitalization*
  • Humans
  • Klatskin Tumor / diagnostic imaging*
  • Klatskin Tumor / surgery
  • Length of Stay
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / surgery
  • Postoperative Complications / diagnostic imaging
  • Surgery Department, Hospital*
  • Young Adult